脊柱结核（spinal tuberculosis）.docVIP

脊柱结核（spinal tuberculosis） Spinal tuberculosis accounts for the first place of tuberculosis of whole body joint, among them vertebral body tuberculosis takes the majority, annex tuberculosis is very rare. The vertebral body is mainly composed of cancellous bone, the nutrient artery is the terminal artery, and the tubercle bacillus is easy to stay in the vertebral body. In the whole spine lumbar activity, lumbar tuberculosis incidence rate is the highest, the second thoracic, cervical more times, as for lumbosacral tuberculosis is very rare. The disease is more common in children, the incidence of diseases over the age of 30 is obviously decreased. Pathology: vertebral tuberculosis can be divided into two types: Central and marginal. 1. centrum centrum tuberculosis: more than lO years old children, good hair in the thoracic spine. The lesion is progressing rapidly and the entire vertebral body is compressed into a wedge. Generally, only one vertebra is invaded and the vertebral column is adjacent to the vertebral body (FIGS. 70, 2). 2. marginal vertebral tuberculosis: more common in adults, the lumbar spine is a predilection site. The lesions are limited to the upper and lower margins of the vertebral body and soon invade the intervertebral disc and adjacent vertebral bodies. Disc destruction is a characteristic of the disease, and the intervertebral space is narrow (FIGS. 70, 2). The cold abscess after vertebral body destruction can have two kinds of manifestations: (1) paravertebral abscess: the pus collects beside the vertebral body and can be in the front, the back or both sides. To accumulate on both sides and in front of more. The pus lifts the periosteum and spreads upward and downward along the ligament space, resulting in bone erosion at the edges of several vertebral bodies. It can also move posteriorly into the spinal canal, pressing the spinal cord and nerve roots. The streamer abscess: paravertebral abscess accumulate to a certain number, the pressure inc